The Medical Skin Clinic

We had not previously rated this service. We rated the service Good overall.

The key questions are rated as:

Are services safe? – Requires improvement

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out an announced comprehensive inspection at The Medical Skin Clinic, Newmarket, Suffolk on 19 July 2023. The service was registered with the Care Quality Commission (CQC) in July 2022. We carried out this first-rated inspection as part of our regulatory functions. The inspection was undertaken to check whether the service was meeting the legal requirements and regulations associated with the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014.

This service is registered with CQC under the Health and Social Care Act 2008 in respect of some, but not all, of the services it provides. There are some exemptions from regulation by CQC that relate to particular types of regulated activities and services and these are set out in Schedule 1 and Schedule 2 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The clinic is registered with CQC to provide the following regulated activities:

Treatment of disease, disorder, or injury

Surgical Procedures

The clinic owner is the registered manager. A registered manager is a person who is registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Our key findings were:

• There were systems to assess, monitor and manage risks to patient safety.
• The provider assessed needs and delivered care in line with relevant and current evidence-based guidance and standards such as the National Institute for Health and Care Excellence (NICE) best practice guidelines.
• Patients’ immediate and ongoing needs were fully assessed.
• Clinicians had enough information to support treatment options so that patients could make an informed decision on which treatment. Leaflets were given to patients to offer information on social pressure that may indicate an incorrect reason to gain aesthetic treatments.
• We saw no evidence of discrimination when making care and treatment decisions.
• Governance arrangements promoted good quality care. Quarterly clinical governance meetings reviewed care, treatment, and outcomes.
• The clinic was responsive to the needs of patients. Staff prioritised the patients’ convenience and ensured appointments ran on time.
• The clinic did not offer walk-in appointments to ensure a thorough assessment of the patient was completed.
• Staff assessed and managed pain where appropriate.
• Follow-up phone calls were completed on all first-time treatment patients. Out-of-hours support was also provided 24 hours a day, 365 days a year for patients to seek advice should they have any concerns.

We saw the following outstanding practice:

• The clinic prioritised patient wellbeing and included in each patient pack, a signposting leaflet for support and advice services.
• COPS Screening (Cosmetic Procedure Screening) was completed on all patients to rule out body dysmorphia. Body dysmorphia is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. Therefore, every patient was evaluated to ensure any procedure was for cosmetic reasons and not due to compulsive behaviours. If the clinic identified body dysmorphia, they would not complete the procedure and referred those patients to specialist support services and the patient’s GP.
• Patients were also offered relevant support or signposted to appropriate support and given 24 hours (or longer) to consider treatments.

The areas where the provider should make improvements are:

• Include treatment considered and discounted within medical consultation notes.
• Only supply unlicensed medicines against valid special clinical needs of an individual patient where there is no suitable licensed medicine available and record discussions within the patient clinical notes.
• Date all sharps bins with dates of opening and closure.
• Ensure a risk assessment for Legionella is carried out and appropriate water testing for is carried out.
• Secure clinical waste in an outside area.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Health Care